mass hiway overview meditech client pilot kick-off

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Commonwealth of Massachusetts Executive Office of Health and Human Services Mass HIway Overview MEDITECH Client Pilot Kick-off June 24, 2013

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Mass HIway Overview MEDITECH Client Pilot Kick-off. June 24, 2013. Mass HIway Overview. - PowerPoint PPT Presentation

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Page 1: Mass  HIway  Overview MEDITECH Client Pilot Kick-off

Commonwealth of MassachusettsExecutive Office of Health and Human Services

Mass HIway OverviewMEDITECH Client Pilot Kick-off

June 24, 2013

Page 2: Mass  HIway  Overview MEDITECH Client Pilot Kick-off

– Hospitals– Health Care Providers– Laboratories– Pharmacies

– Skilled nursing facilities– Public Health Agencies– Health Plans– Patients (future release)

Mass HIway Overview

The Massachusetts Health Information Highway (Mass HIway) enables the secure electronic exchange of health information among diverse participants in the Commonwealth and supports meeting Meaningful Use requirements:

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Page 3: Mass  HIway  Overview MEDITECH Client Pilot Kick-off

MassHIway

Health System

Hospital

Small Practice

Skilled Nursing Facility

Public HealthLaboratory

Pharmacy

Patient (future release)

Health Plan

Hub for Health Information Exchange

1. Patient name 2. Sex3. Date of birth 4. Race5. Ethnicity 6. Preferred language.7. Smoking status 8. Diagnostic codes9. Medications 10. Medication allergies11. Laboratory tests12. Laboratory value/results13. Vital signs (height, weight, BP, BMI)14. Care plan fields, including goals and instructions15. Procedures 16. Care team members17. Immunizations

Depending on the specific application, data exchanged may include:

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Page 4: Mass  HIway  Overview MEDITECH Client Pilot Kick-off

Connection options

Participant directory

Certificate repository

Secure messaging

Message Transformation

Secure web mail

HIway ServicesUser types Methods of connecting to the Commonwealth’s HIE

Connect with local gateway

Browser access to webmail inbox

Physician practice

Hospital

Long-term careOther providersPublic healthHealth plans

Laboratories and imaging centers

Connect through LAND Device(Local Application for Network Distribution)

EHRConnect directly

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Page 5: Mass  HIway  Overview MEDITECH Client Pilot Kick-off

• Participant directory - provides HIway network addresses of all the participants in the network and enables communication via the network

• Certificate repository – holds, manages the private/public key that enables the participant to encrypt and decrypt messages

• Secure messaging - encrypted message will be sent in a secure manner within the network (HL7 2.5.1 format)

• Message transformation – technical format of messages are automatically changed to meet the requirements of the receiving system

• Secure Webmail – secure email and attachments among participants of the network

HIway Services

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Page 6: Mass  HIway  Overview MEDITECH Client Pilot Kick-off

Phase 1 Phase 2HIE

components• Provider directory• PKI infrastructure• Direct/HL7 gateway• Web portal mailbox

• Master Person Index• Record locator service• Consent database• Patient-directed messaging• Query/retrieve infrastructure

HIEend-points

• Any TPO participant

• Public health• SS, CBHI, MIIS

• MassHealth clinical data repository

• Medicaid/HIX participants• Public health

• ELR, PMP, Opioid, Lead

Capabilities phasing plan

A richer set of services available to a broader set of participants

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Page 7: Mass  HIway  Overview MEDITECH Client Pilot Kick-off

SMTP (Push)S/MIME

IMAP (Pull)S/MIME

Mass HIEEmail Server

Mass HIE Direct Gateway

Encrypted XDR

SMTP (Push)S/MIME

Organization ProviderSMTP Server/Client

Organization ProviderXDR

Organization Provider(Direct Enabled)

SMTP Client

SMTP Client Receive

EncryptedXDR

IMAP (Pull)S/MIME

Organization Provider(Direct Enabled)

SMTP Client

Mass HIETransformation

Service

SMTP (Push)S/MIME

IMAP (Pull)S/MIME

SMTP (Push)S/MIME

Organization ProviderSMTP Server

Organization Provider(Direct Enabled)

SMTP Client

Organization ProviderXDR

Mass HIEEmail Server

SMTP Client Send

Direct S/MIME Overview

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Page 8: Mass  HIway  Overview MEDITECH Client Pilot Kick-off

HIway Operations, Services and Support

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Page 9: Mass  HIway  Overview MEDITECH Client Pilot Kick-off

Organization Use Case Status/Target Date

In ProductionBIDMC Several use cases – registries, data

analytics and information exchanged between provider organizations.

• In production: MAeHC; Network Health and DPH – Immunization

• Testing: Boston Public Health; Atrius; Partners and DPH – Lab Reporting

Tufts Medical Center Discharge Summaries to Network Health; • Successful transmission of up to 1M test transactions

• Worked through consent – implementing processes, forms; moving to production with NH – 6/24/13

Network Health Receive Discharge Summaries from Tufts Medical Center and BIDMC

• Production with BIDMC and Tufts Medical Center

HIway Clients: In Production

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Page 10: Mass  HIway  Overview MEDITECH Client Pilot Kick-off

Organization Use Case Status/Target Date Live Holyoke Medical Center/Holyoke HIE

First implementation of Direct connect among Holyoke Medical Center and its HIE, HealthConnect. Successful implementation will allow exchange among the current 43 independent providers, HMC and HIway participants

• Successful test with S/MIME and XDR • Working toward exchange with HIway

customers – Network Health

Beaumont Medical Part of the IMPACT grant with 16 other organizations including Reliant, Metrowest and several LTC facilities

• In process of provisioning services for the other participants

• Move to test with intent to move to production

Dr. Gregory Harris Coordination of behavioral care with multiple facilities

HIway Clients: Live

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Page 11: Mass  HIway  Overview MEDITECH Client Pilot Kick-off

Organization Use Case Status/Target Date

ImplementationBoston Public Health, Atrius, Children’s, Partners

Care coordination, management • Various levels of testing

Harvard Pilgrim Health Discharge summaries; data analytics • Completed extensive security testing – moving to implementation

Metrowest, St. Vincent, Pediatric Care Associates, Notre Dame Long Term Care,

Care coordination • Provisioning with some level of testing

Pilot Project:MEDITECH Pilot Pilot project with 4 MA key MEDITECH

clients• Kick-off session June 24

HIway Clients: Implementation and Onboarding

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Page 12: Mass  HIway  Overview MEDITECH Client Pilot Kick-off

Organization Use Case Status/Target Date

Near Horizon:

Baystate

Opiod Treatment Providers (DPH)

DPH – Immunization, ELR, Syndromic and CBHI

Several – Implementation Grant and PVIX

Intake, Enrollment, Assessment and Treatment

More active outreach to current users of DPH programs to move traffic to HIway

Kick-off expected in July

Provider kick-off – 6/25/13

Ongoing – with more concerted focus beginning in 3rd quarter

Last Mile Program Innovation Implementation Grants

Extensive set of use cases among community providers, local HIEs, facilities and service entities

Active ongoing efforts ; project plans being finalized

HIway Clients: Horizon

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Page 13: Mass  HIway  Overview MEDITECH Client Pilot Kick-off

MA HIway Operating Model

OutreachOutreach SalesSales

ImplementImplement SupportSupport

Select outreach/salesSelect outreach/sales

Operations

Operations

Last Mile

Customer Acquisition Customer Implementation

On-boardOn-

board VerifyVerify ProvisionProvision

OutreachOutreach SalesSales

ImplementImplement SupportSupport

Select outreach/salesSelect outreach/sales

Operations

Operations

Last Mile

Customer Acquisition Customer Implementation

On-boardOn-

board VerifyVerify ProvisionProvision

Pre-Implementation: LM Customer Relationship Managers or through a Service Manager if client is ready for Implementation

Operations: Service Manager as single point of contact supported by Technical Engineers, Operations staff, web portal and 1-855-MA-HIway13

Page 14: Mass  HIway  Overview MEDITECH Client Pilot Kick-off

MA HIway Delivery Model

Client Experience

Project ManagementInstallation

Participant RelationshipCall Center

Back Office Support

ContractsVerificationReporting

BillingDocumentation

Technical ExcellenceEnvironmental Stability

System PerformanceEnhancementsChange ControlComplex Clients

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Page 15: Mass  HIway  Overview MEDITECH Client Pilot Kick-off

HIway Operations Monitoring

To ensure delivery meets objectives , we have and continue to implement operational metrics and performance measures of the end to end process

Date Opened ST# Issue Summary Jira # Escalated Current Status

Last Activity

Days Since Last Activity

Closed Date

Sat. Survey Returned

Total Days Open

2/25/2014 29956 Send/Receive error St. Eligious Alexi Strogonoff ICS-2090 Y Closed 3/2/2014 - 3/2/2014 - 5 2/27/2014 29988 Printing failure General Hospital Bob Adams N Closed 3/3/2014 - 3/3/2014 - 4

3/1/2014 30009 Out of memory message General Hospital Mary Janes N Closed 3/1/2014 - 3/1/2014 9 - 3/1/2014 30058 LAND swap County General Alexi Strogonoff N Closed 3/5/2014 - 3/5/2014 - 4 3/2/2014 30067 Connection not recognized Hope Bob Adams ICS-2099 Y Closed 3/13/2014 - 3/13/2014 - 11 3/2/2014 30069 Password Reset BIDMC Bob Adams N Closed 3/2/2014 - 3/2/2014 10 - 3/2/2014 30071 Password Reset Medical Center Alexi Strogonoff N Closed 3/2/2014 - 3/2/2014 10 - 3/3/2014 30082 LAND swap County General Mary Janes N Closed 3/8/2014 - 3/8/2014 9 5 3/4/2014 30085 Connection not recognized Hope Alexi Strogonoff N Closed 3/10/2014 - 3/10/2014 - 6

Client Metrics Period: 04 Nov 2012 - 10 Nov 2012

System Access Metrics Volume MetricsLogin Access Total Patient Records Total Unique

Total Login as of Last Month 29,521 Total Received as of Last Month 1,009,765 700,543Login This Period 3,236 Received This Period 3,457 2,267Login This Month 4,328 Received This Month 8,564 6,102Total Login To Date 33,849 Total Received To Date 1,018,329 706,645

Patient Records Accessed Total User IDs - Total Total LvL 1 & 2Total Access as of Last Month 10,721 Login IDs Existing Last Month 6,441 1,762Access This Period 1,456 Created This Period 54 0Access This Month 1,823 Created This Month 103 0Total Access To Date 12,544 Total Accounts To Date 6,544 1,762

Break The Glass Attempts TotalTotal Attempted as of Last Month 1,446Attempted This Period 12Attempted This Month 25Total Attempted to Date 1,471

Performance MetricsProduction Environment (Percentage) Total

System Uptime - Period 99.999%System Uptime - This Month 99.999%Portal Uptime - Period 99.999% Direct Secure Messsaging MetricsPortal Uptime - This Month 99.999% Accounts TotalDSM Uptime - Period 100.000% Accounts Existing Last Month 5,503DSM Uptime - This Month 100.000% Created This Period 123

Created This Month 175Outages (Minutes) Total Total Accounts To Date 5,678

Scheduled Outage - Period 5Scheduled Outage - This Month 5 Sent TotalUnscheduled Outage - Period 0 Total Sent as of Last Month 15,245Unscheduled Outage - This Month 2 Sent This Period 3,325

Sent This Month 4,871Security Incidents (Occurances) Total Total Sent To Date 20,116

Incidents Detected - This Period 0Incidents Detected - This Month 0 Received Total

Total Received as of Last Month 32,456Issues Report Total Received This Period 4,235

Issues Created - This Period 1 Received This Month 5,987Issues Resolved - This Period 2 Total Received To Date 38,443Issues Created - This Month 1Issues Resolved - This Month 2Issues Remaining - To Date 5

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Connection Method Client ID Client Name MIIS ELR Syndromic CBHI HIWay

Inbound Transactions

Total Transactions

LAND 12345 Hospital A 255,600 144,450 103,350 34,023 29,902 34,530 601,855 LAND 12346 System B 255,600 144,450 103,350 34,023 29,902 12,340 579,665 LAND 12347 Hospital C 255,600 144,450 103,350 34,023 29,902 9,940 577,265 TOTAL LAND 766,800 433,350 310,050 102,069 89,706 56,810 1,758,785

Outbound Transactions

Transaction Analysis by Client Usage Reports

Request Tracking

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Page 16: Mass  HIway  Overview MEDITECH Client Pilot Kick-off

HIway Environment Monitoring

• State of the art security practices and monitoring of the technical environment has been established to fortify the trust of the HIway use

• 24/7 monitoring of the environment has been implemented – Network, – Applications,– Database, operating systems, – Infrastructure

• Performance thresholds are established to automatically notify and escalate when threshold limits are within range of thresholds for system level agreements

• Within the environment, constant security monitoring and reporting occurs for the following:

– Environment security – identifying access and frequency of changes to the firewall source IP, opened ports in the firewall, changes to the VPN access in the firewall and changes in the IP routing

– Intrusion, penetration monitoring and detection of incidents, vulnerabilities

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Page 17: Mass  HIway  Overview MEDITECH Client Pilot Kick-off

Pilot Proposal to Move Forward

Project Management:• Ryan Thomas: Service Manager

– Will be the single point of contact for the pilot coordination, planning, and oversight of effort, resources within the HIway Operations Team

– Ryan’s contact information• Cell : (781) 790-6101• E-mail: [email protected]

Suggested Next Steps:• Plan

– Plan effort with MEDITECH to test connection with the 3 platforms;– In parallel, begin coordination planning, onboarding with all pilot clients– Ensure that these efforts are in-sync, dovetail with the Implementation Grant plans

• Checkpoint: Status, Go-forward Review • Execute

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